Homebeech

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Requires Improvement: This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, well-being and communication needs with them or their families. People's communication and sensory needs were not always assessed. This meant that people’s needs could not always be met. One person was assessed to need communication aids such as a picture board, but we did not see this being used. Since the assessment, the service have put in more robust processes in place to ensure people’s needs can be met. For example, the service have reviewed all care plans and rated them in priority to ensure that people with most complex needs are assessed as receiving the care and support required.

Staff told us that they speak to people and seek their preferences to ensure they are meeting people's preferences and wishes. Some relatives told us that their loved one's needs are being met. One relative told us, “[Loved one] had improved since coming here. His health has improved.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. This is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The manager and the provider did not understand the substance of these principles therefore, assessments for people with a learning disability were not robust enough to ensure people received sound evidence-based care.

For example, one person’s assessment mentioned behaviour of concern, but the care plan lacked information about how and where it could come about and guidance for staff with how to support the person was limited.

Since the assessment, the provider has confirmed the steps taken to deliver care in accordance with learning disability statutory guidance.

The provider worked well across teams and services to support people. The team worked closely with specialist services and completed appropriate referrals as needed and in partnership with people. The provider worked closely with the enhanced health matron. This helped to mitigate the risk of people having to attend hospital. Local dieticians worked in partnership with Homebeech to monitor people who have specific needs with their diet.

The provider supported people to manage their health and well-being to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service focused on identifying risks to people’s health and wellbeing early and on how to support people to prevent deterioration.

People were involved in regularly monitoring their health, including health assessments and checks where appropriate and necessary with health and care professionals.

However, not everybody was supported to maximise control to live healthier lives. People with a learning disability had no access to kitchens so were unable to participate in ordinary life activities such as being supported in making their own meals or snacks. There was no evidence of an active support approach. Active Support is a method of enabling people with learning disabilities to engage more in their daily lives.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met the social and clinical expectations of people themselves.

For example, one person’s hearing aid kept running out of charge and the service was unable to understand the impact of this for the person. A relative told us, “We had to keep reminding them that [loved one] needed monitoring to ensure hearing aids were working.”

Other feedback was mixed from people and relatives about their involvement with care received at the service. Relatives who had a legal right to be involved, told us they had not been involved in care planning and had not seen care plans.

However, some people and relatives told us they were asked questions about their relatives or loved one’s care and treatment.

The provider told people about their rights around consent and sought people’s views. Family members confirmed discussions were held with families, and we observed in some instances peoples wishes being respected by documenting these in care plans. Staff had a good understanding of gaining verbal consent and described what they would do if a person refused care.